不同方案阴道乳杆菌活菌胶囊结合抗菌药物治疗混合性阴道炎的临床研究

Treatment of mixed vaginitis with different schemes of Lactobacillius DM8909 combined with antibiotics

目的 研究两种阴道乳杆菌活菌胶囊结合抗菌药物对混合性阴道炎的疗效。方法 选取2015年4月至2020年12月北京大学第一医院收治的混合性阴道炎患者50例。同时符合以下两项即确诊为混合性阴道炎:(1)阴道分泌物真菌检测阳性;(2)阴道分泌物革兰染色积分法评分(Nugent评分)≥7分;(3)阴道分泌物滴虫镜检阳性。入选患者根据乳杆菌胶囊使用方法分为联合组(25例)及序贯组(25例),联合组在使用抗菌药物的同时使用阴道乳杆菌活菌胶囊,序贯组在使用抗菌药物结束后序贯使用阴道乳杆菌活菌胶囊。评估两组患者病原体转阴率、症状改善及乳杆菌恢复情况。结果 序贯组患者综合治愈率高于联合组(56.0%vs 28.0%,P<0.05)。经过治疗后,联合组有12.0%的患者阴道菌群恢复为形态类似乳杆菌的革兰阳性大杆菌,序贯组有32.0%恢复为形态类似乳杆菌的革兰阳性大杆菌,两组差异无统计学意义(P>0.05),但序贯组在趋势上高于联合组。结论 对于混合性阴道炎的治疗来说,抗菌药物治疗后序贯使用阴道乳杆菌活菌胶囊优于抗菌药物治疗同时联合使用阴道乳杆菌活菌胶囊。

Objective To observe the effects of two kinds of treatment plan of Lactobacillius DM8909 combined with antibiotics for mixed vaginitis treatment. Methods A total of 50 patients with mixed vaginitis from April 2015 to December 2020 were selected. The inclusion criteria were positive detection of any two of the following:(1) vaginal fungi,(2) Nugent score ≥7, and(3) vaginal trichomonad. The patients were divided into the combination group(25 cases) and the sequential treatment group(25 cases). The combination group was given Lactobacillius DM8909 at the same time of antibiotics administration, while the sequential treatment group was given Lactobacillius DM8909 after antibiotics administration.Results The cure rate in the sequential treatment group was higher than that in the combination group(56% vs 28%,P<0.05). After treatment, 12% of the patients in combination group vs 32% ones in senquential treatment group had their vaginal microflora transfered to Gram positive bacillus-like Lactobacillius. Although there was no significant difference between the two groups, the sequential treatment group showed a better trend. Conclusion As for the treatment of mixed vaginitis, sequential use of Lactobacillius DM8909 following antibiotic therapy is superior to combined use of the two at the same time.